保护性通气策略联合山莨宕碱在大鼠急性肺损伤模型中肺保护作用的研究

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目的:研究肺保护性通气策略联合山莨宕碱在急性肺损伤(ALI)动物模型中的肺保护作用。方法:将40只雌性wistar大白鼠经尾静脉注射油酸制成急性肺损伤模型,随机分成5组(每组8只):A组为对照组;B组为山莨宕碱治疗组(5mg·kg-1·h-1);C组采用大潮气量(15ml·kg-1)进行机械通气;D组采用小潮气量(5ml·kg-1)通气;E组为小潮气量机械通气联合山莨宕碱。分别监测各组治疗前后各时间点的动脉血气和mPAP;治疗4h后,处死大白鼠,取出肺组织,制片后在光镜下观察肺损伤程度。结果:与治疗前相比,A组氧合指数(OI)进行性下降(P<0.05);B组OI呈上升趋势(第3,4h点上升较为明显);D,E两组OI各时点也呈上升趋势,且各时点有显著性差异;C组OI呈先上升(1,2h明显高于其他组)后大幅度下降(在3,4h显著低于其他组)的趋势;E组在3,4h显著高于其他组。A组mPAP呈上升趋势,各时点均显著高于治疗前;B,D,E组呈下降趋势,在2,3,4h点均低于A组;C组前两时点显著低于治疗前和其他各组。C组的肺损伤积分均高于其他组(P(0.05),E组最低,B和D组得的肺损伤积分显著低于A组。结论:保护性肺通气策略联合山莨宕碱对实验性ALI动物模型具有协同治疗效果。 Objective: To study the lung protection effect of pulmonary protective ventilation strategy combined with anisodamine in acute lung injury (ALI) animal model. Methods: A total of 40 female Wistar rats were injected with oleic acid through the tail vein to establish acute lung injury model. They were randomly divided into 5 groups (8 in each group): group A was control group; group B was treated with anisodamine · Kg-1 · h-1). In group C, mechanical ventilation was performed with large tidal volume (15ml · kg-1), group D with low tidal volume (5ml · kg-1) ventilation and group E with small tidal volume ventilation Damp alkali. The arterial blood gas and mPAP were monitored before and after treatment at each time point. After 4 hours of treatment, the rats were sacrificed and the lung tissue was taken out. The degree of lung injury was observed under light microscope after preparation. Results: Compared with those before treatment, oxygen index (OI) in group A decreased progressively (P <0.05); OI in group B showed an upward trend Points also showed an upward trend, and there was a significant difference at each time point. In group C, OI increased first (1,2 h significantly higher than the other groups) and then decreased sharply (significantly lower than the other groups at 3,4 h). E Group 3,4h significantly higher than the other groups. In group A, the mPAP showed an upward trend at all time points, which was significantly higher than that before treatment; while in groups B, D and E, the levels of mPAP tended to decrease, Former and other groups. The scores of lung injury in group C were higher than those in other groups (P (0.05), the lowest in group E, and the score of lung injury in groups B and D was significantly lower than that in group A. Conclusion: Protective pulmonary ventilation combined with anisodamine Animal models of ALI have synergistic therapeutic effects.
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